Agenda

Return

C. 75

To:	Board of Supervisors
From:	William Walker, M.D.
Date:	December 4, 2012

Contra

Costa

County

Subject:

Approval of Contract #74–407-2 with Daniel Forkin, M.D.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/04/2012

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Mary N. Piepho, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Cynthia Belon, 957-5201
cc:	D Morgan D Gary

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: December 4, 2012
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, Contract #74–407-2 with Daniel Forkin, M.D., a self-employed individual, in an amount not to exceed $145,600 to provide professional outpatient psychiatric services, for the period from October 1, 2012 through September 30, 2013.

FISCAL IMPACT:

This Contract is funded 100% by Mental Health Realignment, offset by third-party billing.
(No rate increase)

BACKGROUND:

On September 27, 2011, the Board of Supervisors approved Contract #74-407-1 with Daniel Forkin, M.D, for the period from October 1, 2011 through September 30, 2012 for the provision of professional outpatient psychiatric services for adults in West Contra Costa County.

Approval of Contract #74-407-2 will allow Contractor to continue providing services through September 30, 2013.

CONSEQUENCE OF NEGATIVE ACTION:

If this contract is not approved, County’s clients will not have access to Contractor’s professional outpatient psychiatric services.

CHILDREN'S IMPACT STATEMENT:

Not Applicable